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position, lights and his loupes, and then slowly reads the
record again. Then he slowly looks in the patient’s mouth
at the offending caries. He will take his time examining
the tooth, slowly looking at it from several angles, then
glancing at the record, then back at the tooth. He has seen
it several times before, but just to be sure, he looks at it
again — and again.
Talking slowly, Dr. Slow then advises the patient that an
anesthetic is needed and opens a drawer, slowly selects a
syringe, studies a small stack of loose carpules and selects
one. He then slowly takes it in his hands and inserts it into
the syringe, checks the fit and slowly examines the tip of
the needle as solution is slowly expressed. Then he slowly
brings the syringe to the patient’s mouth, elevates the lip,
slowly examines the injection site and then slowly inserts the
needle into the mucosa, slowly injecting as he slowly drives
the needle tip deeper into the tissues. Taking a minute or so,
he then finishes the injection while he painstakingly moves
the syringe from side to side. He then slowly withdraws the
needle and syringe, taking his time to insert the safety cap
back on the instrument. A 5- to 10-minute wait ensues for
what is deemed “good anesthesia.” After asking the patient
several times if he is numb, poking at the gingiva and any
other tissue within range, Dr. Slow lifts his handpiece and
slowly looks at the bur, then looks away and toward his bur
block for an appropriate bur. He might look at several burs,
slowly considering each one before he makes his selection,
and then slowly pick up a chuck tool to loosen the old bur
and slowly insert the new bur. This process can go on and
on for what seems like forever! I’m sure you get the idea.
Instead of taking five minutes, Dr. Slow takes 30 minutes to
do a simple restoration. We are all more or less guilty of this
type of patient abuse.
Why do we do this? Why is practicing dentistry so slow and
methodical? Why must it take so much time when it really
is not necessary? The reason is simple: We were taught to
be slow in dental school. How many times were we told by
instructors, “Take your time and do it right” or “You’re doing
this too fast”?
ADVANTAGES OF SPEED DENTISTRY
The faster you do something, the quicker you will finish.
If you are torturing (treating) a patient, the faster you do
it, the less discomfort the patient will feel over the length
of the visit. If you are being paid for a treatment and you
do it quickly, then you will be making more money, faster.
If you treat 10 patients an hour rather than 10 patients
in four hours, you will be going home earlier and richer.
The patients will be better served because they will not
have to wait for treatment, and they will spend less time
in the chair and experience less stress. Physiologically,
as adrenalin secretion or stress suppresses the immune
system, less patient stress means less adrenalin secretion
and faster healing.
Another advantage is that you pay less for your staff because
they work fewer hours. However, if you choose to spend
the same amount of time in the office as you did doing
slow dentistry (same basic overhead), you will be able to
treat more people and thus increase your income, try new
techniques you previously didn’t have time for, study or
give more to charity. Speed dentistry has its financial as well
as professional advantages.
Many people object to the concept of speed dentistry
because they believe slow is better than fast, equating
reduced speed to precision. This began in 1900 America
with a great surgeon, Dr. William Halsted, who, after
having a stroke, perfected his technique of general surgery
by methodically going slow. Compared to the slip-shod,
microbe-contaminated surgical techniques of the Victorian
era, the new Halsted technique — along with dependable
anesthesia — produced fabulous results. Unfortunately, it
had an effect on dentistry. In most of our dental school
experiences, instructors believed that procedures done
When dental students are first shown a procedure, it is
usually demonstrated slowly to ensure comprehension. It is
then practiced slowly. Rarely, if ever, are we told or taught
to speed up the process. Unfortunately, this dental school
experience transfers over into real life and our dental
practices. Certainly, when we have a crowded schedule
or have to leave the office early, we speed up and push a
bit, but this is an occasional effort, not a continuous one.
We need to be consistently faster because it is good for
our patients, ourselves, our staff and our profession. With
the right training, equipment and mindset, we can all be
practicing speed dentistry.
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